AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

1. AGING-IN-PLACE AND UNIVERSAL DESIGN A LOOK AT THE HOME AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

2. Presented by: Alissa Boroff, MN-AS, COTA/L, CAPS, CAASH Access Solutions Centrex REHAB George Cundy, A.I.A, CAASH Cundy, Santine & Associates Architects. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

3. 50% of the people in the world have never made or received a phone call. On average 90% of Dutch teenagers can speak fluent English. Only 80% of American teenagers can speak fluent English AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME DEMOGRAPHICS MATTER

4. Generational Identity Generations reflect not only the characteristics of the generation they were born to, but also are influenced by their generational bookends – their parents and children. • groups of individuals born over a 15 to 20 year period who share similar experiences, values, and attitudes during their formative teen and young adult years. • influenced by economic, political and social events of their period. • Each generation includes all kinds of people merged together under a common factor – their age. • Each generation produces a collective “mind set”. • Some are more homogeneous while others have diverse sub-sets with different outlooks and experiences. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

5. Generational Identity Important to understand the differences and similarities in the generations and subgroups. This insight helps to better communicate with these groups. Generations and their generational markers GI’s: Born 1901-1924 5.5 million alive today • America’s first Boy Scouts and Girl Scouts • America’s first “Senior Citizens” • Content to put trust in government • First to benefit from government programs for jobs, education, pensions and health care. • Insist their present phase of life is the best Silents: Born 1925-1945 36 million alive today • Labeled as born either 20 years too early or 20 years too late • Described as overprotected by their parents • Not expected to achieve great things • Excel in personal communication • Proved good at accumulating wealth AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

6. Generational Identity Baby Boomers: Born 1946-1964 More than 77 million alive today • Taught to become critical thinkers • Think they are the biggest and best thing to hit town. MORE ABOUT THE BOOMERS IN A MINUTE Gen Xers: Born 1965 – 1976 50 million alive today • Characterize their parents as self-immersed • Many from split homes due to the spike in the divorce rate. • First “latchkey” kids – learned self-reliance, and independence • Culture shift from “G” rated to “R” rated • Family ties remain strong and open Millennials: Born 1977 – 1994 More than 76 million alive today • Exercise a great deal of influence over a family’ s purchases • Not just good kids – they are thought of as terrific kids • Like security, stability and family – much like the GI’s • Parents obsessed with “parenting” AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

7. MORE ABOUT THE BOOMERS • One in four adults are 50 years old or older. • In the United States over 3.65 million people will turn 65 this year. That is over 10,000 per day or about 1 every 8 seconds and this will continue for the next 19 years • 1.7 million people over the age of 65 die every year but this is expected to diminish as medical science progresses. • 77.3 million American children were born between 1946 and 1964. They are known as the Baby Boomers. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

8. A LOOK AT OUR COUNTRY & THE BOOMERS Born between the years 1946 and 1964. The first of the baby boomers turned 65 in 2011. By the year 2031 they will turn 85. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

9. ESTIMATED AVERAGE NET WORTH OF THE BABY BOOMERS AT AGE 65 AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Source: Calculations based on data form Federal Reserve Board of Governors, “2001 Survey of Consumer Finances,” updated April 29, 2004.

10. Where the Baby Boomers Live AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

11. While we refer to the Baby Boomers as if they were a monolithic whole, they are, in fact, very different. The Baby Boomer generation is made up of 77.3 million individuals. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME The “Leading Edge Boomers” have had a very different life experience from the “Trailing Edge Boomers”.

12. Leading-Edge Boomers: Born 1946-1955 About 37 million alive today Leading Edge Boomers cultural experience includes: • The Cuban Missile Crisis • The assassination of JFK, RFK and MLK Jr. • Political unrest • Walk on the moon • The Vietnam War and anti-war protests • The Sexual revolution • Recreational drug use • The Civil, Environmental & Women’s Rights movements • Woodstock, Motown, The Beatles and Jimi Hendrix • They inherited or will inherit significant wealth and financial optimism from their parents. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

13. Trailing-Edge Boomers: Born 1956-1964 About 40 million alive today Trailing Edge Boomers cultural experience includes: • Watergate and Nixon’s resignation, The Cold War • Oil embargos, gasoline shortages along with Raging inflation • Witnesses to protests not participants. They were Wide-eyed not Tie-dyed. They heard about Woodstock. • Serious heavy drug use and prosecution • Disco & The Bee Gees to Punk Rock and the start of MTV • Often see themselves as a separate overlooked generation or the younger less appreciated siblings of the leading Edge Boomers • They inherited reduced wealth and financial pessimism from their parents AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

14. Rural vs Urban - The Reality • Commonly refer to the 7 county metropolitan area as an urban area. • Reality is that much of this area has more in common with rural factors than urbanor metropolitan factors. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

15. Rural vs. Urban Demographics The Reality • For much of the 20th century, most rural communities experienced population loss as millions of rural residents left for the opportunities in cities. Population losses were common where the agricultural, forestry and mining economy employed fewer workers because of productivity gains. • Currently, 17 % of the U.S. population and 75 % of the land area is classified as nonmetropolitan. • Nonmetropolitan America is extremely diverse with a population, labor force and economy that encompasses far more than agriculture – in fact only about 6.5% of the labor force is engaged in farming AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

16. Rural vs. Urban Demographics The Reality • Net migration to and from rural areas has always been age selective. • People in their 20’s leave; older people tend to stay or return to rural parts of the country. • The typical result is that the average age of residents in rural areas has grown faster than that in urban areas. • This migration trend has produced an age structure in many rural areas that includes few young families and many older adults with a greater need of services. • Now throw into the mix the new reality of destination communities. • Many non-metro areas are seeing, and will continue to see, significant population growth because of scenic landscapes, mild climates and recreational opportunities. • This type of growth has seen an accelerating rate of migration among those in their 50’s and 60’s. • Not only does this type of growth increase the percentage of older residents in an area they are quite likely to stay in their chosen destination community compounding the burden of services that will be needed as they age. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

17. Rural Demographics- The Reality Rural and urban areas differ in terms of demographics, services and social aspects. • 1. Demographic and settlement pattern differences • Low density population and housing • Higher proportion of older residents • Older population is healthier, more able than urban areas • Lower education levels than in urban areas • Lower incomes than in urban areas • Fewer children • Out-migration of 18 to 34-year-olds • In-migration of older adults • 2. Service differences • Greater distances for services • Higher population homogeneity - less social mixing • Fewer housing options • Limited public transportation • 3. Social differences • Higher dependency on smaller group of people • Communities more closed to outside influences • Resistance to change may be higher • Income and education opportunities are lower LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT

18. Aging Demographics of Minnesota • According to the 2010 census Minnesota’s population was 5,303,925 people. • 1.5 million Baby Boomers live in Minnesota. • Minnesota had 2,347,201 housing units with almost a 75% ownership rate. • Currently at 12.9% the 65 and older population is the fastest growing segment of our population. • Minnesota’s senior population is expected to double within the next 20 years. From 600,000 to 1.2 million • From 2,000 to 2,050 the 85 and older population will nearly triple from 90,000 to 250,000. • By the year 2031 nearly 25% of Minnesotans will be over the age of 65. • More will be over the age of 65 than are 14 or younger. • 60% of older adult households include only one adult – leaving them potentially isolated and vulnerable. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Demographic information from Transform 2010 Data Report –Baby Boomer Survey November 2010 and the state demographer.

19. Where the Minnesota Boomers live • 88% live in a single family home. • 90% are satisfied with their housing. • 93% own their homes and plan to continue owning. • 73% have lived in their current home for at least 10 years (39% more than 20 years). • 72% have lived in their current community for at least 10 years (51% more than 20 years). If they were to move… 79% of leading edge boomers and 73% of trailing edge boomers said they would look for a home with single level living. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Demographic information from Transform 2010 Data Report –Baby Boomer Survey November 2010

20. How long do the Boomers plan to stay in their current home? • Nearly 25% of the Boomers plan to remain in their current home for 20 years or more. • In the metro area it is 19% • in greater Minnesota it is 35% The numbers are slightly higher when asked about how long they plan to stay in their current community. Conclusion? AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Minnesota Baby Boomers like where they live! Demographic information from Transform 2010 Data Report –Baby Boomer Survey November 2010

21. BABY BOOMERS IN AMERICA ... • Have enormous impact on communities and the work place. • Boomers now in their mid 60’s to 50’s have no interest in traditional retirement: the “65” number is meaningless. • have good health, enjoy what they are doing, feel that they are good at it and are still adding value to their lives and community. • want to take advantage of this time in their life to explore careers, travel and studies and be a positive force in their world. • They are not moving out of their communities or work place. They are here to stay and demand attention. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

22. So how old is old? • According to a MetLife Mature Market Institute study when Boomers were asked to define “old” the respondents • set the bar for “old” at an average of 79 years – a year older than what was said in 2007. • said that men are old at age 77 • women wouldn’t be old until they were 80. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME • Most men over the age of 65 are married. • Most women over the age of 65 are not married • 80% of elderly women live alone

23. What is Aging-In-Place ? Being able to remain in your home and community safely and as independently as possible, using products, services and conveniences to enable you to not have to move as your circumstances change throughout the maturing years of your life. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

24. AGING IN PLACE • When people speak of aging in place • they do not necessarily mean in the current home they are in • What a majority of them mean is they prefer to stay in their neighborhoods if not their specific homes as they age. • Often they want to stay where they are rather than relocating to facilities away from familiar areas • When mobility becomes a problem, they prefer services be brought to them rather than moving • Don’t want to feel isolated • Want to feel safe AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

25. AGING IN PLACE The housing stock in the United States was built to accommodate the average twenty-five year old healthy male. • The average American home • is over thirty years old • reasonably well constructed • but energy inefficient • often its design presents challenges for even the most able-bodied individuals. • find that we are adapting to our ill-fitted homes rather than making our homes work for us. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

26. AGING IN PLACE Many in the 50+ age group are seeking a home that will allow them to live there as long as they wish. Aging-in-place features in housing help assure that we maintain control over where and how we live, the way we eat, bathe, and sleep, not to mention who visits our home. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

27. AGING IN PLACE Why do people move? The 3 D’s that cause a Non-Discretionary move D D D ivorce eath isease • People often are forced from their homes due to a change in health. Good design of an appropriate environment can help people avoid or mitigate these changes. • Incorporating design features into a home that allow for aging-in-place isn’t complex, difficult or expensive. • Aging-in-place features do not require special trades or unusual techniques. • All that is required is thoughtful design that utilizes everyday items properly installed. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

28. The differences between rural and urban areas lead to differences in service delivery and policy making that affect aging in place. • 1. Rural differences in service delivery • Smaller range of types of services available • Cost for service delivery higher • Expertise lower • Fewer young people to provide services • More need to share services • Regional planning needed • More need for technical and remote innovations in delivery of health services • Critical gaps in housing and transportation important • 2. Rural policy differences • Historically, there has been less concern by policymakers for rural aging in place issues • There typically has been lower funding levels • The focus has been on provision of health services • Zoning regulations often prohibit higher density housing • Policy makers need to factor in higher cost/time for delivery of services • Policy needs to encourage regionalized sharing AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

29. Residents of rural areas tend to value independence, self-reliance and individualism. Although these are positive values, they also contribute to a reluctance to seek helpwhen help is needed. This factor makes it difficult to assess the need for aging-in-place housing in rural areas. Transportation to health-related services is particularly problematic for rural people who may live hours from the nearest service center, clinic, hospital or day program. Nearly 1/3 of the 91 million people in non-metro areas eligible for government transportation funding are transportation dependent, meaning that they have no personal transportation. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

30. Research for AARP’s Beyond 50.05 Study on Livable Communities shows that the most important predictor of successful aging in adults is community attachment. • Older adults reporting that they are “strongly attached” to their communities are more likely to say they are satisfied with life and have a strong sense of self-control and quality of life. • Attachment is stronger for home owners than renters and increases with time. • Correlates with staying healthy and active, with working and volunteering, organizational memberships, civic participation, attendance at community events, and, for some, religious involvement. • The study also found that levels of community attachment and engagement are strongly affected by home and community features. • Homes that are accessible in their original design or through modification improve satisfaction, and community stability AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

31. The satisfaction of successful aging is also determined by how well home and community are linked through mobility options, including driving, accessible public transportation, and walking and bicycling. Walking and bicycling must be facilitated by provision of safe streets and sidewalks. Aging in Place Score Card 1. Community is friendly to people of all ages 2. Health and Human Services 3. Transportation and Mobility 4. Public Safety 5. Housing 6. Finance Services 7. Workforce Development 8. Civic Engagement and Volunteer Opportunities 9. Culture and Lifelong Learning 10. Public Policy and Zoning 11. A Good Place to Grow Up and Grow Old AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

32. As the population ages, the demand for affordable, accessible housing is growing -- but the supply of suitable homes has not kept pace with the demand. • Local efforts in rural areas to build new accessible housing or make existing homes accessible, are gradually increasing the rural stock of homes that meet the needs of the aging population. • But zoning restrictions and lending policies are slow to change, and often present obstacles to building or financing homes with what are considered by some as "unusual" features. • But even when zoning and financing are not a challenge, people looking for a home in which they can age-in-place have all too often found find the designers and builders are not aware of -- or interested in -- design elements critical to creating an such a dwelling. • Builders often don't understand that relatively minor changes in the design of a home, for example; widening doorways, providing a roll-in shower or replacing a step with a ramp can make a home suitable for a person with a variety of abilities. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

33. If people are going to age in place we need to do a number of things. • We need to provide housing and communities where they can live a safe, secure, healthy life style. • We need to acknowledge and understand that they will need more and more services as they age. • A key decision to be made is whether we • bring aging people together to deliver services OR • we modify where they live and deliver services to them. • most likely will be a decision driven by economics as the overwhelming needs fall to the government to meet. • urban areas may be less expensive to deliver services while in rural areas it may be that we need to gather people together to make service delivery affordable. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

34. WHAT DOES ALL THIS HAVE TO DO WITH UNIVERSAL DESIGN ? • It is the changing health and abilities of the Baby Boomers that is driving the implementation of Universal Design. • this group of people may differ in experiences, they are used to having things their way and expect places, products and services to accommodate their needs. • They want to live where they are until they decide to move, they want that move to be discretionary. • They think of themselves as young, healthy and vital and do not want their environment to cause them to think otherwise AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Universal Design (UD) goes a long way to providing them the freedom to live where they want and how they want.

35. Universal Design (UD) Defined Universal Design is an approach to design of all products and environments to be as usable as possible by as many people as possible regardless of age, ability or situation without the need for adaption or specialized design AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

36. 7 BASIC PRINCIPALS OF UNIVERSAL DESIGN Equitable Use – the design is useful and marketable to people with diverse abilities. 2. Flexibility in Use – the design accommodates a wide range of individual preferences and abilities. 3. Simple and Intuitive – use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level 4. Perceptible Information – the design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities. 5. Tolerance for Error – the design minimizes hazards and the adverse consequences of accidental or unintended actions. 6. Low Physical Effort – the design can be used efficiently and comfortably with a minimum of effort or fatigue. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME 7. Size and Space for Approach and Use – appropriate size and space is provided for approach, reach, manipulation, and use regardless of users body size, posture or mobility.

37. or if you prefer - 5 BASIC PRINCIPALS of a Universal Design Home 1. Usable – Designs are uncomplicated, safe, well suited to their purpose, and can be easily used by people with differing abilities. 2. Adaptable – The home can be cost effectively and simply adapted to meet people’s changing needs over time, or to suit different users. Accessible – Everyone can easily access the home and move around freely within it. Particular attention will have been given to transition points such as pathways and doorways, and access to and from transport. Inclusive – The design accommodates everyone regardless of age, size, or ability. Groups are not segregated by the design. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME Lifetime Value – Homes incorporating Universal Design are not expensive, but they are valuable and remain so over time. They save the user money, time and energy through effective design.

38. UNIVERSAL DESIGN (UD) Confusion and misperceptions concerning Universal Design have come about in part because of a linkage with the Americans with Disabilities Act (ADA) and in part because of linkages with high-tech and very expensive ways of making items adapt to different users. UD accommodates young people, older people, tall and short people, thin and stout people, and others who are non-average as well as people with disabilities. UD is often low-tech, simple and inexpensive. The most successful universal design means that neither items nor users need to adapt for successful use. Universal Design makes homes and communities livable for people of all ages and abilities.Universal Design helps make a home a more pleasant place to live now and helps avoid unnecessary hassles and expensive changes in the future. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

39. Clarifying what Universal Design is NOT • Accessible design – building or housing units that meet prescribed requirements for accessibility. Requirements vary by the applicable code. • In public/commercial buildings – must comply with ADA accessibility guidelines. • allows full wheelchair access. • ADA guidelines do not apply to single-family residences. • Americans with Disabilities Act (ADA) – a major civil rights law that prohibits discrimination on the basis of disability in the public and private sector. It covers employment, public services, public accommodations, and telecommunications. • Adaptable design – includes features that can be easily modified by removing barriers and/or adding accessible elements to meet the changing needs and requirements of an individual. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME • VISIT-ability – includes a level, zero-step entry to a home, and maneuvering space within the ground floor of the home. Access to one bathroom or powder room on the ground floor

40. Designing for Aging in Place Older people with age-related changes • Tend to not have one severe disability – but many difficulties that cause different problems at different times. • May have a chronic condition that has led to a disability. • Tend to utilize traditional channels for care. • Tend to seek direction from their physician or service provider • Are reluctant to appear less than able. • See themselves as active and healthy but may have difficulties with daily tasks. • One of the reasons they resist adaptions that are assistive in nature may be the desire to continue to be perceived as healthy and active and not in need of assistance • -Most importantly they • DO NOT CONSIDER THEMSELVES DISABLED!! AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME

41. The average person can expect to experience a disability at some point in their lives. • Chronic conditions such as obesity, diabetes, arthritis and over/under use of medications show no age boundaries and affect both young and old. • By virtue of getting older all of us are confronted with a variety of diminishing abilities. AGING-IN-PLACE AND UNIVERSAL DESIGN: A LOOK AT THE HOME In order to successfully implement Universal Design for our aging population it is helpful to understand the physical changes they are undergoing and the effects those changes can have on their life style.

42. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT • A brief • look at the Aging Process

43. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Promoting Aging in Place What if we incorporate rather than modify? • The Pro-Active approach • Accommodates permanent or occasional limitations • Limits dependency • Is easily adaptable • Is cost effective • Stark (2004) found that after receiving modifications, participants experienced significant increases in participation and satisfaction • Cumming, et al. (2001) found that environmental changes (e.g. leaving the light on at night) decreased fall risk

44. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Promoting Aging in Place What if we incorporate rather than modify? • Outcomes • Reduce future health care costs • Prevent/reduce falls & injuries • Promote active living Aging in Place & Universal Design are not Accessible Design, it is smart design for long term Living

45. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Universal Design can Promote Independence and Prevent Accidents • Often times poorly designed and maintained environments are hazardous and contribute to falls and injuries. • Home modification and repair can help prevent accidents and falls. The National Center for Disease Control (CDC) suggests that 1/3 of home accidents can be prevented by modification and repair. • UD features can enhance comfort, increase safety, prevent injuries, and facilitate ongoing access to community support and services. • Removing barriers and safety hazards also helps reduce stress associated with reduction in physical capabilities as people age.

46. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Considerations for Aging and Special Needs • General Aging Impairments • Progressive Disorders • Sensory Impairments • Touch • Pain • Smell • Hearing • Vision • Cognitive impairments • Decreased judgement • Decreased sequencing / organizing skills • Motor impairments • Wheelchair users • Ambulation device users • Fine motor skill impairments • Gross motor impairments

47. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT • How we use sensory information • Info gathering • Warning mechanism (protective sensation) • Communication • Pleasure/enjoyment

48. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Olfactory (Smelling) Changes • Age-related changes • Related to exposure over lifetime rather than age • Sense of smell can fatigue (becoming accustomed to a constant smell) • Medical conditions that can affect smell • Dementia • Parkinson’s • Sinus infections • Other

49. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT • Hearing • Our ’24-hour’ monitoring system • Excess noise can cause irritability, raise blood pressure, decrease problem solving skills • Individuals with hearing loss may withdraw from social activities, are at higher risk for personal safety and increased risk for depression • Hearing loss • Thought to be due to accumulation of noise damage over the years • Elders in less technologically advanced cultures do not experience hearing loss to the same extent as in our society

50. LET’S DEFINE UNIVERSAL DESIGN: WHY IT IS IMPORTANT Hearing Impairments • Age-related changes that can affect hearing • Collapsing of the auditory canal cartilage • Earwax thickening • Decreased ability to hear high frequency sounds • Increased auditory processing time • Decreased auditory discrimination • Medical conditions that can impact hearing • Measles • Meningitis • Ear infections • Lengthy antibiotic use • Lengthy diuretic use • Other % percentage of individuals with significant hearing impairments